Table of Contents
| Preface | ix |
| 1. When Plagues End | 3 |
| 2. Virtually Abnormal | 89 |
| 3. If Love Were All | 175 |
| Select Bibliography | 254 |
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Chapter One
1. WHEN PLAGUES END
The sense of what is real ... the thought
if after all it should prove unreal...
--Walt Whitman, Leaves of Grass
FIRST, THE RESISTANCE to memory.
I arrived late at the hospital, fresh off the plane. It was
around 8:30 and there was no light on in my friend Patrick's
apartment, so I went straight to the intensive care
unit. When I arrived, my friend Chris's eyes were a reddened
blear of fright, the hospital mask slipped down
under his chin. I went into the room. When I first caught
sight of Pat, he was lying on his back, his body contorted
so his neck twisted away and his arms splayed out, his
hands palm upward, showing the intravenous tubes into
his wrists. Blood mingled with sweat in the creases of his
neck, his chest heaving up and down grotesquely with
the pumping of the respirator, a huge plastic tube forced
down his throat. His cold feet poked out from under the
bedspread, as if separate from the rest of his body.
The week before, celebrating his thirty-first birthday in
his hometown on the Gulf Coast of Florida, we had swum
together in the dark, warm space he had already decided
would one day contain his ashes. It was clear that he had
known something was about to happen. One afternoon on
the beach, he had gotten up to take a walk with his newly
acquired beagle, and had glanced back at me a second
before he left. All I can say is that, somehow, the glance
conveyed a complete sense of finality, the subtlest but
clearest sign that it was, as far as he was concerned, over.
Within three days, a massive fungal infection overtook his
lungs, and at midnight, the vital signs began to plummet.
I remember walking slowly back to the intensive care
room when a sudden rush of people moved backwards out
of the room. His brother motioned to the rest of us to run,
and we sped toward him. Pat's heart had stopped beating
and after one attempt to restart it, we surrounded him and
prayed: his mother and father and three brothers, his
boyfriend, ex-boyfriend and a handful of close friends.
When the priest arrived, each of us received communion. I
remember I slumped back against the wall at the moment
of his dying, reaching out for all the consolation I had been
used to reaching for--the knowledge that the worst was
yet to come, the memory of pain survived in the past--but
since it was happening now, and now had never felt so
unavoidable, no relief was possible.
Perhaps this is why so many of us have found it hard
to accept that this ordeal may be over. Because it means
we may now be required to relent from our clenching
against the future and remember the past.
IF I COULD PINPOINT a moment when the reality sunk
in for me, it was a summer evening in 1996. I was at
the July 30 meeting of something called the Treatment Action
Group, an AIDS activist organization, in Manhattan.
In its heyday, in the early 1990s, this group had lived
and breathed a hard-edged skepticism. They were, after
all, the no-nonsense successors to the AIDS action group,
ACT UP. But as soon as I arrived--for a meeting to discuss
the data presented at a recent AIDS conference--I could
sense something had changed. Even at eight o'clock, there
was a big crowd--much larger, one of the organizers told
me, than the regular meetings. In the middle sat David
Ho, a pioneering AIDS researcher, and Marty Markowitz,
the doctor who had presided over some of the earliest
clinical trials of the new "combination therapy" for HIV
infection. As the crowd stared at them and they stared
nervously back, the two scientists interspersed their whispers
to one another with the occasional, gleeful smile.
The meeting began with a blur of data. Ho and Markowitz
detailed again what had already hit the headlines:
how, in some trials of patients taking the new protease
inhibitors used in combination with older AIDS drugs, the
amount of virus in the bloodstream had been reduced
on average by between a hundred- and a thousand-fold.
Within a few weeks of treatment with the new drugs, they
elaborated, levels of up to six million viral particles in a
milliliter of a patient's blood had been reduced to below
four hundred in most cases. That is, no virus could be
found on the most sophisticated tests available. And, so
far, the results had lasted.
When Ho finished speaking, there was, at first, a
numbed silence. And then the questions followed, like
firecrackers of denial. How long did it take for the virus
to clear from the bloodstream? What about the virus still
hiding in the brain or the testes? What could be done for
the people who weren't responding to the new drugs? Was
there resistance to the new therapy? Could a new, even
more lethal viral strain be leaking out into the population?
The answers that came from Ho and Markowitz were just
as insistent. No, this was not a "cure." But the disappearance
of the virus in the bloodstream was beyond the expectations
of even the most optimistic of researchers. It was
likely that there would be some impact on the virus--although
less profound--in the brain or testes, and new
drugs were able to reach those areas better. And since the
impact of the drugs was so powerful, it was hard for resistance
to develop because resistance is what happens when
the virus mutates in the presence of the drugs--and there
was no virus detectable in the presence of the drugs.
The crowd palpably adjusted itself; and a few rusty office
chairs squeaked. These were the hard-core skeptics, I
remember thinking to myself, and even they couldn't disguise
what was going through their minds. There were
caveats, of course. The latest drugs were very new, and
large studies had yet to be done. There was already clinical
evidence that a small minority of patients, especially
those in late-stage disease, were not responding as well
to the new drugs and were experiencing a "breakout" of
the virus after a few weeks or months. Although some
people's immune systems seemed to recover, others'
seemed damaged for good. The long-term toxicity of the
drugs themselves--their impact on the liver and heart, for
example--could mean that patients might stage a miraculous
recovery at the start, only to die from the effects of
treatment in later life. And the drugs themselves were
often debilitating. After testing positive in 1993, I had been
on combination therapy ever since. When I added the protease
inhibitors in March of 1996, the nausea, diarrhea,
and constant fatigue had been overwhelming.
But I remember that meeting all too vividly now, and the
simple, unavoidable future it presaged. The next day, in a
friend's apartment, I spoke the words I never believed I
would speak in my lifetime. "It's over," I said. "Believe me.
It's over."
MOST OFFICIAL STATEMENTS about the disease, of course--the
statements by responsible scientists, by AIDS activist
organizations, by doctors--do not concede that the
plague is at an end. And, in one vital sense, obviously it's
not. In the time it takes you to read this sentence, someone
somewhere will be infected with HIV. Worldwide, the
numbers affected jump daily--some 30 million human
beings at the latest estimate. Almost all of these people--and
a real minority in America--will not be able to have
access to the treatments now available. And many, many
of these people will still die. Nothing I am saying here is
meant to deny that fact, or to mitigate its awfulness. I am
not saying here (nor would I ever say) that some lives are
worth more than others, or that some lives are worth more
attention than others. To speak of the experience of some
is not to deny the experience of others or to deny its importance.
But it is not illegitimate to speak of what you know,
while conceding a large part of what you do not know. And
there is a speciousness to the idea that what is true is somehow
untrue because it isn't everything.
So I do not apologize for the following sentence. It is
true--and truer now than it was when it was first spoken,
and truer now than even six months ago--that something
profound in the history of AIDS has occurred these last
two years. The power of the new treatments and the even
greater power of those now in the pipeline are such that a
diagnosis of HIV infection in the West is not just different
in degree today than, say, in 1994. For those who can get
medical care, the diagnosis is quite different in kind. It no
longer signifies death. It merely signifies illness.
This is a shift as immense as it is difficult to grasp. So let
me make what I think is more than a semantic point: a
plague is not the same thing as a disease. It is possible,
for example, for a plague to end, while a disease continues.
A plague is something that cannot be controlled, something
with a capacity to spread exponentially out of its borders,
something that kills and devastates with democratic
impunity, something that robs human beings of the ability
to respond in any practical way. Disease, in contrast, is generally
diagnosable and treatable, with varying degrees of
success; it occurs at a steady or predictable rate; it counts
its progress through the human population one person,
and often centuries, at a time. Plague, on the other hand,
cannot be cured, and it never affects one person. It affects
many, and at once, and swiftly. And by its very communal
nature, by its unpredictability and by its devastation,
plague asks questions disease often doesn't. Disease is
experienced; plague is spread. Disease is always with us;
plagues come and go. And some time toward the end of the
millennium in America, the plague of AIDS went.
You could see it in the papers. Almost overnight, toward
the end of 1996, the obituary pages in the gay press began
to dwindle. Soon after, the official statistics followed.
Within a year, AIDS deaths had plummeted 60 percent in
California, 44 percent across the country as a whole. In
time, it was shown that triple combination therapy in
patients who had never taken drugs before kept close to
90 percent of them at undetectable levels of virus for two
full years. Optimism about actually ridding the body completely
of virus dissipated; what had at one point been
conceivable after two years stretched to three and then
longer. But even for those who had developed resistance
to one or more drugs, the future seemed tangibly brighter.
New, more powerful treatments were fast coming on-stream,
month after month. What had once been a handful
of treatment options grew to over twenty. In trials, the
next generation of AZT packed a punch ten times as powerful
as its original; and new, more focused forms of protease
inhibitor carried with them even greater promise.
It was still taboo, of course, to mention this hope--for
fear it might encourage a return to unsafe sex and a new
outburst of promiscuity. But, after a while, the numbers
began to speak for themselves.
It remains true, however, that anyone who even understood
the minimal amount of the science could have
predicted these figures as early as 1995. By that steamy
summer night in 1996, the implications were unavoidable,
and you could sense it in the air. After the meeting, as we
spilled out into the street, a slightly heady feeling wafted
over the crowd. A few groups headed off for a late dinner,
others to take their protease drugs quickly on an empty
stomach, others still to bed. It was after ten o'clock, and I
remember wandering aimlessly into a nearby bar, where
late-evening men in suits gazed up at muscle-boy videos,
their tired faces and occasional cruising glances a weirdly
comforting return to normality. But as I checked my notebook
at the door and returned to the bar to order a drink,
the phrase a longtime AIDS activist had spoken to me earlier
that day began to reverberate in my mind. He'd been
talking about the sense of purpose and destiny he had
once felt as part of his diagnosis. "It must be hard to find
out you're positive now," he had said, darkly. "It's like you
really missed the party."
AT SIX O'CLOCK in the morning in Manhattan's Roseland
Ballroom, the crowds were still thick. I'd arrived four
hours earlier, after a failed attempt to sleep beforehand. A
chaotic throng of men crammed the downstairs lobby,
attempting to check coats. There were no lines as such,
merely a subterranean, almost stationary mosh pit, stiflingly
hot, full of inflated muscular bodies, glacially drifting
toward the coat-check windows. This was, for some,
the high point of the year's gay male social calendar. It's
called the Black Party, one of a series of theme parties
held year-round by a large, informal group of affluent,
mainly white, gay men and several thousand admirers.
It's part of what's been dubbed the "circuit," a series of
vast, drug-enhanced dance parties held in various cities
across the country, and now a resilient, if marginal, feature
of an emergent post-AIDS gay urban "lifestyle."
Until the late 1990s, almost nothing had been written in
the mainstream media about these parties, except when
they had jutted their way into controversy. A new circuit
party, called "Cherry Jubilee," in Washington, D.C.,
incurred the wrath of Congressman Robert Dornan for tolerating
drug use in a federal building leased for the event.
The annual Morning Party in August in Fire Island, held to
raise money for Gay Men's Health Crisis in New York, was
criticized on similar grounds by many in the gay world
itself. But slowly, the proliferation of these events (they
numbered at least two a month in cities as diverse as
Miami and Pittsburgh) became impossible to ignore, and
the secrecy that once shrouded them turned into an increasingly
raucous debate on the front pages of newspapers
across the country. Despite representing a tiny
sub-subculture and dwarfed, for example, by the explosion
of gay religion and spirituality in the same period,
the parties seemed to symbolize something larger: the
question of whether, as AIDS receded, gay men were prepared
to choose further integration, or were poised to
leap into another spasm of libidinal pathology.
The Black Party, like all such events, was made possible
by a variety of chemicals: steroids, which began as therapy
for wasting men with AIDS, and became a means to perpetuate
still further the cult of bodybuilding; and psychotherapeutic
designer drugs, primarily Ecstasy, ketamine
(or "Special K"), and "crystal meth." The whole place, without
this knowledge, could be taken for a mass of men
in superb shape, merely enjoying an opportunity to let
off steam. But underneath, there was an air of strain, of
sexual danger translated into sexual objectification, the
unspoken withering of the human body transformed into
a reassuring inflation of muscular body mass.
I had never known these events in their heyday, in the
late 1970s and early 1980s. Begun in a legendary disco
in Manhattan, the Saint, they had mesmerized an entire
generation of homosexual urbanites. I was taken to one
in the mid-1980s, as the plague had begun to descend, but
even then, its effects were hard to determine. What you
saw was an oasis of astonishing masculine beauty, of a
kind our society never self-consciously displays in the
open. I remember feeling at first a gasp of disbelief, a
sense that, finally, I was surrounded by visions that had
once only existed in my head. These people were not
boys, they were men. And they were not merely men,
they were men in the deepest visible sense of that word,
men whose muscular power flickered in the shadows,
men whose close sweat and buzzed hair and predatory
posturing intimated almost a parody of the masculine,
men whose self-conscious sexuality set them apart from
the heterosexual world--and indeed from the homosexual
world outside the hallowed precepts of this space.
What would the guardians of reality think, I remember
asking myself, if they could see this now, see this display
of unapologetic masculinity, and understand that it was
homosexual?
The critics of these events have predictably lambasted
this glorification of the masculine. They have seen in it an
echo of the gender oppression directed by straight men
against gay men and lesbians and heterosexual women, an
appropriation by homosexuals of the very male supremacy
that stigmatizes and marginalizes them. And indeed,
in the darkness of that night there was an unmistakably
Darwinian element to the whole exercise. While the slim
and effeminate hovered at the margins, the center of the
dance floor and the stage areas were dedicated to the most
male archetypes, their muscles and arrogance like a magnet
of self-contempt for the rest. But at the same time, it
was hard also not to be struck, as I was the first time I saw
it, by a genuine, brazen act of cultural defiance, a spectacle
designed not only to exclude but to reclaim a gender, the
ultimate response to a heterosexual order that denies gay
men the masculinity that is also their own.
And much of it was not merely playacting. To be sure,
if you looked around, you saw an efflorescence of masculine
symbolism that was as strained as it was crude.
Thick torsos, bull necks, and ribbed abdominals were
draped with the paraphernalia of the archetype: leather,
sports clothes, sneakers, tank tops, tattoos. But behind it,
a more convincing affect: beyond the dancing and socializing,
a kind of circling, silent interaction, a drifting,
almost menacing, courtship of male brevity and concision.
It was raw male sexuality distilled, of a kind that unites
straight and gay men and separates them from women:
without emotion, without knowledge, without apparent
weakness, armored with testosterone and an almost
marblelike hardness of touch.
There was a numbness to it, as well. The first few times
I went to these events, I made an elementary mistake of
trying to engage my fellow partiers, of trying to catch
their eyes or strike up conversation. But they were anesthetized,
almost as if this display was only possible by
distancing themselves from their mental being, pushing
themselves into a drug-induced distance from their minds
and others', turning their bodies into images in a catalogue
whose pages they turned, in a bored, fitful trance.
And as the night stretched into morning, and as the drugs
reached their peak in the bloodstream of these masses,
the escape became more complete, the otherness more
perfect, the paradox of reclaiming their selves more intense
as the outside world got up, made coffee, and busied
itself about the day. I remember once leaving one of
these parties at 11:30 in the morning, a dark, cavernous
blur of flesh and body still imprinted on my mind when,
in an instant, we were thrust out onto the streets of Manhattan,
unthinking strangers walking briskly past in the
bright whiteness of a cloudy morning. None of this, I felt,
cared for us; none of it even knew of us. Which was both a
thoroughly depressing and energizing thought.
What these events really were not about, whatever
their critics have claimed, was sex. And as circuit parties
intensified in frequency and numbers in the 1990s, this
became more, not less, the case. When people feared that
the ebbing of AIDS would lead to a new burst of promiscuity,
to a return to the 1970s in some mindless celebration
of old times, they were, it turns out, only half right. Although
some bathhouses revived, their centrality to gay
life all but disappeared. What replaced sex was the idea
of sex; and what replaced promiscuity was the idea of
promiscuity, masked, in the burgeoning numbers of circuit
parties around the country, by the ecstatic high of
drug-enhanced dance music. These were not merely mass
celebrations on the dawn of a new era; they were raves
built upon the need for amnesia.
They were, of course, built on drugs. And the kind of
drugs was as revealing as the fact of them: Ecstasy, a substance
that instantly simulated an intimacy so many men
found almost impossible to achieve, and an exhilaration
they could not otherwise allow themselves to feel; ketamine,
a powder that tipped them into an oblivion a part
of them inwardly craved; crystal meth, a substance that
gave them an endurance and power they hadn't yet been
able to attain for real; and anabolic steroids--literally,
injected masculinity--providing an illusion of male self-confidence
where far too little of it existed for real. These
drugs are illusions--pathetic, debilitating--and also telling
illusions. They are rightly seen as the antithesis of the
new era of responsibility and maturity the end of AIDS
actually promised. But they are also, perhaps, merely the
cheapest version of such an era, lasting hours, not decades,
and bought with money, not life.
In the circuit parties you see perhaps the double-edged
nature of a segment of gay male sexuality as clearly as
anywhere else: the physical shallowness and emotional
cowardice, the cult of youth, and the longing for masculinity;
but also the desperate need for belonging, for
support and reassurance, above all for intimacy, for a
world which can offer gay men, if only they could seize it,
the chance for the emotional reality which this spectacle
of alienation merely intimated and postponed.
As the early morning stretched on, my friends and I
stood in the recess of a back bar as the parade of bodies
passed relentlessly by. Some of them glided past, intent on
some imminent conquest; others stumbled toward me,
eyes glazed, bodies stooped in a kind of morbid stupor,
staring at the floor or into space; others still stood in corners,
chatting, socializing, their arms draped around each
other, a banal familiarity belying the truly bizarre scene
around them. Beyond, a mass of men danced the early
morning through, strobe lights occasionally glinting off
the assorted deltoids, traps, lats, and other muscle groups.
At the party's peak--around 7 a.m.--there must have been
around six thousand men in the room, some parading on a
distant stage, others locked in a cluster of rotating pectoral
muscles, embracing each other in a drug-induced
emotional high. And then the habitual climax, the sound
of the Black Party's signature song, "Left to My Own Devices,"
a gay elegy of longing and detachment, descended
on the scene:
I could leave you,
Say Goodbye.
I could love you,
If I tried.
And I could.
And left to my own devices, I probably would.
And as the music pounded, and the men swarmed
closer together, and the posture of maleness and intimacy
melded into one hazy blur of movement, I found
myself moving quietly away. For a group of men who had
just witnessed a scale of loss normally visited only upon
war generations, it was a curious spectacle. For some, I'm
sure, the drugs helped release emotions they could hardly
address alone or sober; for others, the ritual was a way of
defying their own infections, their sense of fragility or
guilt at survival. For others still, including myself, it was a
conflicting puzzle of impulses. The need to find some solidarity
among the loss, to assert some crazed physicality
against the threat of sickness, to release some of the toxins
built up over a decade of constant stress. Beyond
everything, the desire to banish the memories that will
not be banished, to shuck off--if only till the morning--the
maturity that plague had brutally imposed.
But even so, I couldn't be among them. It was too much
to experience--at least, not together.
[CHAPTER ONE CONTINUES ...]
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